乳腺癌新辅助化疗联合保乳术患者血清P-selectin与CA15-3、TPA水平的相关性及与预后的关系#br#

摘要/Abstract

摘要： 目的：探讨乳腺癌新辅助化疗联合保乳手术患者血清可溶性P选择素（P-selectin）水平与糖类抗原15-3（CA15-3）、组织多肽抗原（TPA）水平的相关性，分析以上几种指标的水平与乳腺癌患者预后的关系。方法：选取我院2016年5月至2020年5月收治的97例临床资料齐全的乳腺癌患者进行回顾性队列研究。患者均行新辅助化疗+保乳手术治疗，术后随访2年，根据医嘱定期复查。于治疗前及术后1、6个月复查时采血，检测血清P-selectin、CA15-3、TPA水平。根据随访结果将患者分别纳入预后不良组（n=34）和预后良好组（n=63），比较两组患者血清P-selectin、CA15-3、TPA水平；经Pearson线性相关分析血清P-selectin水平与CA15-3、TPA水平的相关性。比较不同临床分期、分子分型患者的血清P-selectin、CA15-3、TPA水平。结果：预后不良组与预后良好组患者术后1、6个月的血清P-selectin、CA15-3、TPA水平均低于治疗前。预后良好组患者治疗前及术后1、6个月血清P-selectin、CA15-3、TPA水平均低于预后不良组（P＜0.05）。Pearson线性相关分析显示，患者治疗前及术后1、6个月的血清P-selectin水平与CA15-3、TPA水平呈正相关（P＜0.05）。ⅡA期、ⅡB期乳腺癌患者治疗前及术后1、6个月血清P-selectin、CA15-3、TPA水平低于ⅢA期乳腺癌患者（P＜0.05）；Luminal A+B型、Her-2过表达型乳腺癌患者术后1、6个月血清P-selectin、CA15-3、TPA水平低于三阴性型乳腺癌患者（P＜0.05）。结论：乳腺癌新辅助化疗+保乳手术患者治疗前及术后1、6个月的血清P-selectin、CA15-3、TPA水平增高与远期预后密切相关，且不同临床分期与分子分型患者的血清P-selectin、CA15-3、TPA水平存在差异，临床需密切监测乳腺癌患者以上指标水平的变化，尽早预测预后。

关键词: 乳腺癌, 新辅助化疗, 保乳手术, 可溶性P选择素, 糖类抗原15-3, 组织多肽抗原

Abstract: Objective： To explore the correlation between serum soluble P-selectin (P-selectin) level and carbohydrate antigen 15-3 (CA15-3) and tissue polypeptide antigen (TPA) levels in breast cancer patients receiving neoadjuvant chemotherapy plus breast-conserving surgery， and to analyze the relationship between the levels of the above indexes and the prognosis of breast cancer patients. Methods： A retrospective cohort study was conducted on 97 breast cancer patients with complete clinical data who were admitted to our hospital from May 2016 to May 2020. All the patients were treated with neoadjuvant chemotherapy plus breast conserving surgery and were followed up for 2 years after surgery， and followed up regularly according to medical advice. Blood samples were collected before treatment， one month after surgery and 6 months after surgery to test serum P-selectin， CA15-3， and TPA levels. According to the follow-up results， the patients were included in the poor prognosis group (n=34) and the good prognosis group (n=63)， respectively. Serum P-selectin， CA15-3 and TPA levels were compared between the two groups of patients. The correlation between P-selectin， CA15-3 and TPA levels was analyzed by Pearson linear correlation. The serum P-selectin， CA15-3 and TPA levels of patients with different clinical stage and different molecular type breast cancer were compared. Results： The serum P-selectin， CA15-3 and TPA levels of patients in the poor prognosis group and the good prognosis group at 1 and 6 months after surgery were lower than those before treatment. Serum P-selectin， CA15-3 and TPA levels of patients in the good prognosis group were lower than those of the poor prognosis group before treatment and at 1 and 6 months after surgery (P<0.05). Pearson linear correlation analysis showed that serum P-selectin level was positively correlated with CA15-3 and TPA levels before treatment， 1 month after surgery and 6 months after surgery (P<0.05). The serum P-selectin， CA15-3 and TPA levels of ⅡA stage and ⅡB stage breast cancer patients were lower than those of ⅢA stage breast cancer patients before treatment and at 1 and 6 months after surgery (P<0.05). The levels of P-selectin， CA15-3 and TPA of patients with Luminal A+B type and Her-2 overexpression type breast cancer were lower than those of the triple-negative type breast cancer at 1 and 6 months after surgery (P<0.05). Conclusion： The increase of serum P-selectin， CA15-3 and TPA levels before treatment and 1 and 6 months after surgery in patients receiving neoadjuvant chemotherapy plus breast preservation surgery is closely correlated with long-term prognosis of the patients， and the serum P-selectin， CA15-3 and TPA levels of breast cancer patients in different clinical stages and with different molecular types are different. It is necessary to closely monitor the changes of the above indexes in breast cancer patients to predict the prognosis as soon as possible.

Key words: Breast cancer, Neoadjuvant chemotherapy, Breast-conserving surgery, Soluble P-selectin, Carbohydrate antigen 15-3, Tissue polypeptide antigen

中图分类号:

R737.9

徐子森, 申武峰. 乳腺癌新辅助化疗联合保乳术患者血清P-selectin与CA15-3、TPA水平的相关性及与预后的关系#br#[J]. 中国医药导刊, 2023, 25(10): 1029-1034.

XU Zisen, SHEN Wufeng. Correlation of Serum P-selectin Level with CA15-3 and TPA Levels in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy Plus Breast-Conserving Surgery and Its Relationship with Prognosis#br#[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(10): 1029-1034.

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